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General NPI Number Information
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NPI Number | 1497255004
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Entity Type | Organization
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Legal Business Name | SOCIAL PERSPECTIVE, LLC
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 211 E. 8TH STREET, #C
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City | LAWRENCE
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State | KS
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Zip | 66044
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Country | US
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Telephone | 785-371-6554
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Fax |
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Provider Business Mailing Address
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Address Line | 4116 SPRING HILL DRIVE
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City | LAWRENCE
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State | KS
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Zip | 66049
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Country | US
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Telephone | 785-371-6554
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEREDITH SUE VERNON
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Credential | PH.D.
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Telephone | 785-371-6554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4658
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License Number State | KS
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